Efficacy of flurbiprofen axetil for preventing postanesthetic shivering in patients undergoing gynecologic laparotomy surgeries

Insights into Prospects of Novel NSAID Prodrugs in the Management of Gastrointestinal Toxicity: A Perspective Review

Non-steroidal anti-inflammatory drugs (NSAIDs) have a long history in the healthcare system due to their therapeutic potential. These NSAIDs cause ulcerogenicity, stomach pains, gastrointestinal hemorrhage, mucosa bleeding, and pancreatitis when used moderately and consistently. With researchers, managing the aforementioned adverse effects therapeutically is getting increasingly difficult. One method for creating NSAID moieties with low penetration as well as ulcerogenic properties is the prodrug technique. During the oral consumption of NSAID-prodrugs, ulcerations, intestinal hemorrhage, and mucosa hemorrhage have significantly decreased. Considering this background, this review focussed on NSAID prodrugs as well as their justifications, the pathogenesis of NSAIDs inducing gastrointestinal toxicity, and the role of different antioxidants and spacer groups. Prodrug moieties have more advantages over parent medicines concerning both solubility and lipophilicity. In general, NSAID-class prodrugs can successfully treat both acute and long-term inflammation and aches without causing ulcerotoxicity and related gastrointestinal side effects, which reduces their burden from the pharmacoeconomic perspective.

Effect of Lung Protective Ventilation Combined With Flurbiprofen Axetil on Immune Function During Thoracoscopic Radical Resection of Lung Cancer

The decreased immune function of patients with lung cancer has always been the focus of clinical attention. However, the stress response caused by surgery, anesthesia and pain will further reduce the body's immune function and affect the prognosis of patients to a certain extent. It was found that both protective ventilation and flurbiprofen ester pretreatment could reduce the immunosuppression caused by stress response. In this study, 120 lung cancer patients treated with video-assisted thoracoscopic radical resection were divided into group A, group B, group C and group D, which were treated with conventional mechanical ventilation, lung protective ventilation, conventional mechanical ventilation + flurbiprofen axetil and lung protective ventilation + flurbiprofen axetil, respectively. The results showed that the levels of CD3+, CD4+, CD4/CD8+, and NK in groups A, B, and C were lower than T0 on T1, T2, and T3, while those indicators in group D were lower than T0 on T1 and T2 (P < 0.05). The above indicators in group D were higher than those in the other three groups on T1, T2, and T3 (P < 0.05). The above indicators were statistically significant compared with those in group A and group C, group B and group D, and group A and group B at T1, T2, and T3 (P < 0.05). The comparisons of CD3+, CD4+, CD4/CD8+, and NK among the four groups within different time groups, and the repeated - measures analysis of variance (repeated - measures ANOVA) showed that there were interactions among time, group, and between groups × within groups (P < 0.05). It was confirmed that lung protective ventilation combined with flurbiprofen axetil could alleviate the immunosuppression of patients undergoing thoracoscopic radical lung cancer, providing a new idea for clinical treatment.

The analgesic effect and inflammatory mechanism of nonsteroidal analgesics combined with nerve block in post-gynecologic surgery patients

OBJECTIVE

To investigate the analgesic effect and inflammatory mechanism of nonsteroidal analgesics combined with nerve block in post-gynecologic surgery patients.

METHODS

Sixty patients who underwent gynecological laparotomies in our hospital were enrolled in this retrospective cohort study, with 30 patients administered nonsteroidal analgesics combined with nerve block (the observation group) and 30 patients administered nonsteroidal analgesics alone (the control group). The patients in the observation group were administered an intravenous injection of flurbiprofen axetil 1 mg/kg before the end of the operation, and 0.375% ropivacaine was used for bilateral transversus abdominis plane block after the operation. The patients in the control group were administered only an intravenous injection of flurbiprofen axetil 1 mg/kg before the end of the operation. The blood pressure (BP), heart rate (HR), visual analogue scale (VAS) scores, and the numerical rating scale (NRS) scores were recorded before the operation (T0) and at 1 h (T1), 6 h (T2), 12 h (T3), and 24 h (T4) after the recovery from the anesthesia. The incidences of emergence agitation, and the operation and recovery times in the two groups were recorded. Blood samples were collected before and at one day after the operations to measure the inflammatory factor levels such as IL-6, IL-1β, and TNF-α.

RESULTS

The BP, HR, and the VAS and NRS scores in the observation group at T1, T2, T3, and T4 were lower than they were in the control group (P<0.01). The inflammatory factor levels after the operation in the observation group were lower than they were in the control group (P<0.01). There was no significant difference in the incidences of complications between the two groups (P>0.05).

CONCLUSION

Flurbiprofen axetil combined with ropivacaine for bilateral transversus abdominis plane block has a significant analgesic effect on patients after gynecologic surgery. The mechanism may be due to the fact that nonsteroidal analgesics combined with nerve block further reduce the inflammatory factors in the body, which proves the superiority of multimodal analgesia.